The Supreme Court decided in 2012 to let states choose whether to expand Medicaid as it was intended under the Affordable Care Act. Now, more than a year and a half later, after reviewing proposals from the state house, the senate, and panels of stakeholders, Governor Herbert finally revealed his plan.

“I want to tell you that after a thorough analysis and careful consideration, I’m convinced today that the best pathway forward for Utah is not to pursue an expansion of the federal Medicaid program,” Herbert told reporters.

But he still wants those federal dollars to come to Utah. He just wants them in the form of a block grant. Herbert said the state has a moral obligation to take care of the poorest Utahns, and to make sure its citizens get the maximum benefit from the taxes they pay.

“If the federal government will just block grant us the money, take away the strings, and give us maximum flexibility, we will find innovative ways to do things better, more effectively, and more efficiently,” Herbert said.

The governor’s proposal would take the federal money that would have gone into Medicaid and give it to Utahns to buy insurance on the private market. A single person who makes less than $15,500 per year would qualify. The Department of Health estimates that the plan would help about 111,000 people to get health insurance. Herbert’s proposal would bring the same amount of money into the state that a traditional Medicaid expansion would have, but it requires approval from the federal government. The governor seems optimistic after his latest visit to Washington.

“The president told me, we’re looking for more flexibility. If you’ve got a better way to do things, come talk to me about it,” Herbert said. “Based on our conversations, I’m extremely confident that it’s going to work out, so stayed tuned.”